NINTH ANNUAL YEAR BOOK— PART X 465 
and between the digits of each foot. Eruptions similar to those within 
the mouth make their appearance upon these swollen regions of the foot 
a day or two later, and at this stage it is usual to find that like lesions 
have made their appearance upon the perineum of the victim. In the 
case of milch cows the udder and more particularly the teats show the 
same vesicular eruption, but later as the result of milking soon become 
covered with reddened spots deprived of the superficial layer of skin and 
may develop deep, obstinate fissures. 
As soon as the disease has become well established the patient evinces 
pain when attempting to eat; in fact, the appetite is often so seriously 
affected that all food is refused and the animal uneasily opens and shuts 
its mouth with a characeristic smacking sound, while strings of cohesive, 
ropy saliva hang suspended from the lips. With the advance of the dis- 
ease the vesicles have widened and extended until they may reach a 
diameter from that of a dime to that of a silver dollar. These ruptures, 
soon after their appearance, sometimes on the first day, more rarily on 
the second or third day. After they have ruptured the grayish white 
membrane forming the blister may remain attached for a day or more 
or disappear speedily and leave deeply reddened sensitive spots or ero- 
sions behind, both wdthin the mouth and upon the coronet and between 
the claw^s of the feet. The same ulceration may be noticed in cases in 
which the teats of milch cow^s have become affected, and instances are 
reported in which sloughing of the tegument immediately around the 
ulcer upon the udder has occurred. Owing to the tough, fibrous nature 
of the bovine skin, it is exceeding rare for sloughing to occur upon any 
part of the body other than those mentioned. 
The attack upon the feet of an animal is frequently manifested in all 
four feet at once, but one or more of the feet may entirely escape and 
remain unaffected throughout the course of the disease. As the feet be- 
come sensitive and sore the animal lies down persistently, and it has 
been found that bed sores develop with amazing rapidity in all such cases 
and wholly baffle all attempts at treatment until after the patient has 
regained its feet. 
The disease may attack some of the internal organs before it appears 
upon any of the external tissues. These cases are very liable to prove 
quickly fatal. The animal dies from paralysis of the heart due to the 
formation of poisonous principles wathin the system, or it may suffocate 
by reason of the action of these same poisons upon the tissues of the 
lungs, or it may choke to death as a result of paralysis of the throat. 
In cases of serious affection of the udder the erosions will often be 
found located within the passages of the teats, resulting in a "caked" 
udder, and the same toxic poisoning, which is the cause of death in the 
apoplectiform types just mentioned, may arise from this source. In any 
event the milk from such cases will be fond dangerous for use, causing 
fatal diarrhea in sucking calves or young pigs and serious illness in 
human consumers. The milk obtained from cows suffering wath foot- 
and-mouth disease is not readily converted into either butter or cheese, 
but remains thick, slimy, and inert in spite of churning and attempts at 
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